I am a relatively new hospital manager. I inherited a team that is severely challenged when it comes to communication, attitude, and accountability. Recently, one of my nurses threw what I would call “an adult temper tantrum” after receiving her assignment. She threw down her reports and complained loudly and inappropriately in front of both the day and night shift nurses. She also walked out of my daily briefing before I was finished—in front of the rest of the team. I attempted to fix her assignment for her, as her objections were not unreasonable, but her behavior certainly was. She verbalized that she would keep the assignment as it was but had a very bad attitude for several hours.

I’m working hard on my “story” because I feel very disrespected and embarrassed by her behavior. Since she was so emotional I chose not to confront her at the time. But I’m thinking I need to speak up now. Since she can be quite volatile, can you give me some advice? I’m worried she’s influencing her teammates against me.

Sincerely,
Committed to Following Up

Dear Committed,
First of all, congratulations on your promotion. It sounds like you’ve had the job long enough to realize management isn’t all golf and long lunches. The resort doesn’t always resemble the brochure, does it?

You’ve done a couple of things right already. First of all, you were wise to respond to the content of her concern in order to demonstrate that you cared about her problem. You were wise to not confront her in front of her peers, or to do so when her emotions were very strong. Had you done so, it would have been difficult for her to hear you, and your influence would have diminished significantly.

Second, offering to make appropriate adjustments to the assignment—so long as you weren’t selling out by doing so—is a good way of creating safety. It shows that you care about her interests and sets a foundation of mutual purpose.

But from there, I think you missed a big opportunity by not raising your concerns with her behavior at the same time you offered to respond to her complaints. The ideal moment to hold someone accountable is the moment they are least likely to misunderstand your intentions. And that moment was probably when you genuinely and sincerely attempted to listen to her issue.

With that said, all is not lost. But you must address this issue soon before you run the risk of seeming like you’re dredging up old issues—or worse, before it happens again and you feel even more upset when you talk with her.

So do it soon. Do it privately. Do it at a time she agrees to and which is convenient for her. All of these situational factors will help her feel more safe.

Begin by reminding her of the reason she should know she is safe with you. Point out what you’ve done to address her frustrations, and reiterate that you will always be accommodating to personal needs when you can do so without being unfair to the rest of the team.

With that said, now it’s time to raise your concern. And this is the tricky part. You’ve got two things you’ve got to do to turn this into a healthy Crucial Confrontation.

First, frame the issue positively. Ensure that she knows your intent is to address a problem and not to beat her up. For example, “I’d like to talk to you about something that happened when you were frustrated with the assignment I gave you. In doing so, I want you to know it will always be okay for you to tell me things don’t work for you. What I’d like to address is how you did it. Because that was unacceptable. May I describe my concern?”

With her consent, you must now describe her behavior but not your judgments. When we’re upset with others, we often make veiled attempts to punish them by describing their behavior in inflammatory ways. For example, it will not work to say, “You were hostile and insulting when you got your assignment.” Carefully plan out how you’ll describe her behavior, and carefully replace all the “hot words” with descriptive rather than judgmental language. For example, you might say, “After you read your assignment you said in a loud voice, ‘No way.’ You then put a stack of reports you were holding down on the desk abruptly enough that they made a noticeable noise. And finally, you referred to me as a ‘Snot-nosed kid’ who you said would not tell you what to do.”

It’s vital in maintaining safety that these words be spoken in a matter-of-fact tone of voice. They will carry far more weight in the conversation if you don’t hurl them. Let the words do their own work. If they are true, your nurse will hear them better without your added force.

Next, you need to tell her why this doesn’t work for you. For example, “I’ve got two problems with what happened. First, it was done publicly. This affects morale in our team and encourages insubordination. That doesn’t work for me. Second, it was accusatory. It seemed like you were turning this into a personal attack on me. You didn’t need to. I will listen to your concerns when you have them. But this kind of behavior makes it harder for me to respond in a supportive way.”

Now you need to ask for her point of view. See if she remembers it differently or disagrees with your judgment of what happened. Once you’ve worked through your points of view, you must end by asking for her commitment to behave differently in the future.

Finally, if you think there is a chance this behavior will be an ongoing problem, you should ask for a chance to follow up and check in with her on two fronts: a) does she feel she’s getting support from you? and b) are you satisfied that she is supporting you? Agree on a specific date and then follow up.

Good luck in your new responsibilities. The way you address this very crucial issue will set a pattern for how you’ll be as a manager. Do it well, and you’ll have a long career of success ahead of you.

Joseph Grenny is a New York Times bestselling author, keynote speaker, and leading social scientist for business performance. For thirty years, Joseph has delivered engaging keynotes at major conferences including the HSM World Business Forum at Radio City Music Hall. Joseph’s work has been translated into twenty-eight languages, is available in thirty-six countries, and has generated results for three hundred of the Fortune 500. read more